title: An international survey of pediatric apheresis practice.
abstract: BACKGROUND
  Pediatric apheresis (PA) has distinct characteristics compared to adult apheresis, and requires specialized knowledge and experience to perform safely, particularly in low-weight patients. As evidence-based medicine advances the field of therapeutic apheresis, increased attention must be paid to pediatric patients with conditions for which apheresis is indicated.
  
  
  METHODS
  An electronic survey of >5,000 potential participants throughout the world was conducted to ascertain the scope and the current state of practice.
  
  
  RESULTS
  The survey elicited 159 responses from 12 countries; 107 of the responses provided sufficient information for analysis. Participants performed an average of 176 PA procedures/year (range: 1-2,000). The types of PA procedures were therapeutic plasma exchange (92% of centers), red cell exchange (86%), leukocyte depletion (87%) and peripheral blood hematopoietic progenitor cell collection (72%). More than 65% of the centers had treated children older than 5 years with PA. Many centers had also performed PA on younger children; 40% have treated patients <12 months of age; 61% had treated patients 1-5 years old. 36% of centers reported that they would perform apheresis regardless of patient weight; 18% used a 5 kg threshold, 11% used 5-10 kg, and 17% used 10 kg as their weight threshold.
  
  
  CONCLUSIONS
  This report is the largest single survey of centers performing PA. The results provide information about the scope and diversity of PA and identify areas where considerable variability in practice exists. Further exploration of these differences could establish best practices in PA through international research and collaboration.
authors.affiliation: Puget Sound Blood Center, Seattle, Washington; Department of Laboratory Medicine, University of Washington, Seattle, Washington; Seattle Children's Hospital, Seattle, Washington.
authors.forename: Meghan
authors.initials: M
authors.lastname: Delaney
authors.forename: Kelley E
authors.initials: KE
authors.lastname: Capocelli
authors.forename: Anne F
authors.initials: AF
authors.lastname: Eder
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schneiderman
authors.forename: Joseph
authors.initials: J
authors.lastname: Schwartz
authors.forename: Steven R
authors.initials: SR
authors.lastname: Sloan
authors.forename: Edward C C
authors.initials: EC
authors.lastname: Wong
authors.forename: Haewon C
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use; D001781:Blood Component Removal; D001782:Blood Donors; D057785:Catheters; D002648:Child; D002675:Child, Preschool; D008078:Cholesterol, LDL / Q000302:isolation & purification; D005112:Extracorporeal Circulation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017893:Photopheresis
chemical_list: D000925:Anticoagulants; D008078:Cholesterol, LDL
keywords: apheresis; infant; pediatric; plasma exchange; survey